Boardroom Brief: The Board’s Role in Addressing Societal Drivers that Influence Health

Social Drivers

Background

Hospitals are thinking differently about providing care and advancing health for their patients in partnership with their communities with an eye toward improving health. As hospitals and health systems work to improve health for the patients and communities they serve, they recognize the necessity of addressing the myriad non-medical factors that drive health outcomes.

An individual’s ability to achieve good health is influenced by more than just access to high-quality medical services. Eighty percent of health outcomes are shaped by other social drivers of health, such as conditions in which people are born, grow, work, live and age. These factors include safe and stable housing, access to food and transportation, education, social connection, safety and environmental exposures.1 It is the air we breathe, the homes we live in, the food we eat, the jobs we do and where we send our kids to school. But if our air is not clean, our home is not safe, our food is not nutritious, our job does not provide a living wage or our children do not receive a quality education, health inevitably suffers in the short and long term.

While these adverse social drivers can impact anyone, people from historically marginalized communities are disproportionately affected, contributing to the persistence of health inequities.

Not only is addressing social drivers good for patient care and aligned with many hospitals and health systems’ missions, but it may also serve as an avenue to meet strategic goals such as improving quality and outcomes, reducing costs and building community engagement and trust.

Board Brief: The Board’s Role in Addressing Societal Factors that Influence Health page 1.

 

Addressing the full scope and complexity of the social drivers that influence health is a massive, multi-sector undertaking. As cornerstones of their communities, hospitals and health systems play a key role — in partnership with other stakeholders — to positively impact the health of the patients and communities they serve.

The Social Drivers of Health: A Framework for Improving Health Outcomes

The AHA has developed numerous resources to support hospitals in addressing this challenging yet essential work. The Social Drivers of Health: A Framework for Improving Health Outcomes guides hospital leaders’ thinking about how they can impact these social drivers at three levels, moving from individual to systemic. While this work may seem daunting, the framework strives to provide an accessible approach and clarifies the role that hospitals and health care organizations can take. These approaches are complementary; each is necessary but not sufficient to tackle these complex societal issues.

The Role of Hospital and Health System Boards in Addressing Social Drivers that Influence Health

Board members should be knowledgeable of the social drivers that influence the health and well-being of the patients and communities they serve and how their organization addresses these factors. Below are four roles trustees can play to help their organizations:

1. Community Connector

Trustees, as representatives of their communities, serve as a link between the hospital and the community. They can facilitate community conversations through the community health assessment (CHA) process and foster relationships with community stakeholders through formal and informal community engagement strategies.

2. Leading Stakeholder

Board members can hold hospital leaders accountable for identifying and reaching health goals. Hospital and health system boards should ensure their organizations have the infrastructure needed to implement strategies that address social drivers. By establishing board committees focused on health, integrating social drivers into goals and metrics and aligning this work with strategic priorities, trustees can hold leaders accountable for making progress.

3. Advocate

As leaders in their communities, trustees can advise local and federal policymakers to adopt policies to address the social drivers that influence health in various sectors.

4. Advisor

Trustees can share their observations about community health needs and advance their understanding of what hospitals can do to address social drivers. Using these insights, trustees can engage with hospital leaders about how to best implement sustainable solutions to address social drivers. This could include advising on community benefit spending and other investments that impact patients and community members.

Trustee Discussion Questions

  1. What social needs are most prevalent in our patient population? How do we know? Which populations are most affected?
  2. What actions can we take at each layer of the Social Drivers that Influence Health Framework? In what areas could our hospital lead, and where would we need to partner?
  3. How are social drivers represented in our hospital’s strategic plan? Are they connected to quality or any other strategic performance goals?
  4. How can our social drivers and health strategies be tied to the CHA and improvement plan?
  5. What are three priority areas that we could focus on to improve outcomes by addressing social drivers?
  6. What policies can our hospital advocate for to address social drivers? What policy or environmental changes would make a difference in our community?
  7. What type of partners do we need to advance work on social drivers? What partners are available in our community? What resources can our hospital or health system contribute?

AHA Resources

  1. https://www.countyhealthrankings.org/what-impacts-health/county-health-rankings-model

Key Resources