Being born into poverty, growing up with curtailed opportunities for education and employment, living in a disadvantaged neighborhood — these factors, called social determinants of health, are like the cards you’re dealt in a game of poker. It’s hard to win if the deck is stacked against you.
Social determinants of health are the economic and social conditions that affect your health, such as the environment in which you are born, grow, live, work and age. They generally refer to factors that affect health outside of the healthcare system and that are beyond an individual’s control. These include socioeconomic status, level of education, physical environment, employment status and social support networks, as well as access to healthcare.
Ample scientific evidence shows that social status, typically measured by income or education, may be the most significant shaper of health, disability and life expectancy.
Ample scientific evidence shows that social status, typically measured by income or education, may be the most significant shaper of health, disability and life expectancy. Social factors, including education, racial segregation, social supports and poverty, accounted for over a third of total deaths in the U.S. in a year.
In recognition of this, Baylor Scott & White Health’s Community Advocates Program is working to care for the whole patient by identifying and meeting needs both inside the hospital and out.
An innovative approach to caring for the underserved
The multi-faceted Community Advocates Program connects vulnerable patients to the community-based resources they need to be healthy by utilizing a network of student volunteers, clinical and front-line staff, and local community organizations. This innovative initiative pairs trained, volunteer local university students — called Community Advocates — with clinicians who then connect them with underserved patients in need of access to community resources. These resources, including everything from child care to education and transportation, help meet critical clinical, social and spiritual needs.
The ultimate goal is to improve their wellbeing and reduce the future need for healthcare services, while simultaneously lowering the burden often placed on the healthcare system.
In supervised clinical settings, Community Advocates provide powerful intervention, potentially transforming the lives of underserved patients whose needs may otherwise go unmet. The ultimate goal is to improve their wellbeing and reduce the future need for healthcare services, while simultaneously lowering the burden often placed on the healthcare system.
In 2016, Baylor Scott & White was the first health system in Texas to implement this program at two sites, Baylor Scott & White Medical Center – Carrollton and the Nurse Family Partnership in Waco. Since then, it has grown to 10 sites across the state, with 670 patients screened and 26 students enrolled to date. The program is credited with an 87.5 percent decrease in 30-day readmission rates to the emergency department.
Related: Why value-based care is the key to high-quality, affordable healthcare
Training the next generation of healthcare workers
The program is as life-changing for the student volunteers engaged as Community Advocates as it is for the patients who receive assistance. The Community Advocate Program recruits volunteers through partnerships with Baylor University, the University of Mary Hardin-Baylor, the University of Texas at Dallas and the University of North Texas. After a “boot camp” training, students shadow a clinical team to learn the skills necessary to provide case management and guide patients to the resources and agencies that can fulfill their social needs.
“This position has helped me burst out of my bubble and experience different realities. It also has made me understand that when serving in healthcare, you can follow a model, but this model has to be adjusted to each patient’s set of needs.” —Larissa Hagge Fernandes
Students pursuing careers in healthcare have a unique opportunity to develop skills and knowledge that can only be gained through working in the patient care setting. Real-world patient interactions put classroom teachings into practice, often with eye-opening results.
“Being an advocate is humbling,” said Larissa Hagge Fernandes, a healthcare management student at the University of Texas at Dallas. “This position has helped me burst out of my bubble and experience different realities. It also has made me understand that when serving in healthcare, you can follow a model, but this model has to be adjusted to each patient’s set of needs.”
The experiences gained through being a Community Advocate also teach these aspiring healthcare professionals the need for and power of compassion for those in need, a lesson that cannot be taught in the classroom.
“In my future career, I’ll be more involved with the business side of healthcare,” Larissa said. “This experience has taught me that a person’s health is influenced by many factors and their health also impacts different areas in their lives. For that reason, I will always remember that the business of healthcare and my professional decisions will impact the wellbeing of individuals and communities.”
In several different avenues, this program is working to build a better, healthier future — for these patients and also for the future of healthcare.
Learn about other community outreach programs empowering healthier communities across the state.
About the author
Steve is a senior marketing and public relations consultant for Baylor Scott & White Health. He spent nearly four decades in newspaper and magazine editorial and business management and is the author of two books on healthcare reform. He was also the founding editor of D Magazine's D Healthcare Daily.
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