Physicians Foundation offers insights on social drivers of health

The Physicians Foundation in August announced its latest open application period for an award and grant proposal that aim to connect doctors with their patients social drivers of health.

The Dr. Buz Cooper Award and the Drivers of Health Grant Program have taken root in recent years for physicians who work with patients and the social factors outside traditional medicine that influence patient health.

This video features commentary from three experts: Physicians Foundation President Gary Price, MD, MBA; Deborah Rose, MD, a neurology specialist and 2024 Physicians Foundation research fellow; and Jubril Oyeyemi, MD, FHELA, founder and CEO of the Cherry Hill Free Clinic in New Jersey, and recipient of the 2024 Dr. Buz Cooper Award for Addressing Drivers of Health.

The following transcript has been lightly edited for style and flow.

The Physicians Foundation has offered financial support for doctors willing to study five factors that affect patient well-being outside the examination room: food security, housing stability, transportation access, utilities access and interpersonal safety.

Gary Price, MD, MBA: Things which don't normally get addressed in an office setting, but which can have an enormous impact on health outcomes.

Jubril Oyeyemi, MD, FHELA: It's the environment we live in. It's access to food, transportation, getting utilities paid, housing — that's a big one.

Price: It's been estimated actually that 60% of our health care spending is a direct result of those upstream drivers of health, rather than the medications or even advice we dispense in our offices.

For some, the focus on drivers of health is relatively new across medicine. In 2016 the physicians Foundation supported the late Dr. Richard “Buz” Cooper in publishing "Poverty and the Myths of Health Care Reform," a book-length study that proposed social factors that were influencing patient health and health care costs.

Price: His book's really an inflection point in our attitudes towards the impact of drivers of health. But he very conclusively, in a very simple, readable way, showed how actually that if you looked at patients' ZIP codes, that the explanation for these differences in cost actually broke down quite dramatically on the basis of poverty and some of the side effects of that, that, in fact, it was our poorest neighborhoods where the costs of health care were actually the highest.

The Physicians Foundation has evidence that doctors support this approach in U.S. health care.

Deborah Rose, MD: One of the most amazing things that's come out of our the survey that The Physicians Foundation administered, the results of which we saw in 2022, found that eight in 10 physicians reported that we can't really improve health outcomes or reduce health care costs without addressing drivers of health.

Another study found in 2022, 27% of physician practices systematically screened for five drivers of health, up from 15% in 2017 and a full 67% of practices screened for at least one of the five.

Rose: So the fact that we in this study, there are more than two thirds of physicians reporting that they are screening or that they are at least having some engagement with drivers of health is very encouraging to see. Hopefully that number goes up even higher, because, you know, you can't separate the impact that someone's health related social needs, whether that's access to transportation, financial stability, being able to get access to good, nutritious food — all of that has an impact on how well we can provide the medical care for them.

Going forward, awareness, education, financing and teamwork, all will be part of the movement to address patients' social drivers of health.

Rose: When I was in medical school, when I started nearly a decade ago, we didn't talk as much about these health-related social needs, as we're doing now, and that's unfortunate. It starts when we are in medical school, and it goes from there, you know, building that foundation from early on is really critical to continue that same practice when we become independent physicians. So, education is a huge one. Incentivizing the screenings that many clinicians are doing now is another big one. And the last thing I'll say is, we need to implement more support networks and resources within these offices for clinicians.

The Physicians Foundation has created an award in Dr. Cooper's honor to recognize physicians who take innovative approaches to drivers of Health. Dr. Oyeyemi was the 2024 recipient for his work at the Cherry Hill Free Clinic, which he started in New Jersey.

Oyeyemi: It's become my why in medicine, because what we do is provide medical care at zero charge to New Jerseyans who can't afford health insurance. And so we've done that since 2017, eight years now, to the tune of over 8,000 patients and almost 10,000 encounters and this is with the help of just incredible providers and nonclinicians who just give, you know, come volunteer their time to help their neighbors who won't otherwise have access to it. There's so much more that affects our health beyond medicines, pharmacies, and if you look at some data, even from the World Health Organization, that really only about 11% of well-being is ascribed to to medicine, right? And this is something that primary care providers like myself are constantly, constantly talking about. And we're realizing more and more that these struggles actually can alter your well-being, the core of your well-being, your DNA. And so we have to pay more attention to it.