227688 A community health center-based model to address social determinants of health and advance health equity

Monday, November 8, 2010

Rishi Manchanda, MD MPH , Program in Social Medicine and Health Equity, St.John's Well Child and Family Centers, Los Angeles, CA
Background: Community Health Centers were founded on a Community-Oriented Primary Care Model, which integrates medicine, public health and social justice work. The emergence of a dominant biomedical model for healthcare delivery has shaped the “professionalization” of health centers, which now provide direct health services to 20 million Americans. Community health centers are well-positioned to effectively address social determinants of health and health disparities beyond the provision of direct health care services, but limited models exist.

Methods: In 2008, St.John's Well Child and Family Centers, a large community health center network in South Los Angeles, founded the Program in Social Medicine and Health Equity (PSM&HE) to address upstream determinants of health and serve as a catalyst for community health. Promotoras, tenant organizers, public interest lawyers, housing advocates and other partners contribute to program design, implementation and evaluation, including the development of social medicine core competencies for clinicians.

Results: The PSM&HE has expanded clinic capacity for human rights-based advocacy, community-engaged research and education, and a biosocial model of health care, in which all clinicians help address substandard housing, food insecurity, and other health determinants. Results include improvements in patient health outcomes, increased clinician knowledge and skills relating to social determinants of health, improved research infrastructure, increased patient awareness and community mobilization.

Conclusion: The PSM&HE represents a transformative community-led model for effectively integrating a social determinants of health framework into a community health center, and achieving measurable improvements in health.

Learning Areas:
Advocacy for health and health education
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Provision of health care to the public

Learning Objectives:
At the end of the session, participants will be able to 1) describe a community health center-based model for addressing social determinants of health and 2) discuss the implications of a community health center-based biosocial approach for patients, clinicians, health care delivery, and local health equity collaboratives.

Keywords: Community Health Centers, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a primary care doctor at a community health center and the Director of Social Medicine and Health Equity. I work extensively in collaboration with community partners to advance health equity.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3161.0: CBPR Approaches to Engaging Communities to Change Health Outcomes