Bob Underwood, MD (Host): Health equity is the fair and just opportunity for everyone to achieve their highest level of health, meaning patients have access to the resources, tools, and high quality care they need to thrive today and in the future. This is Pediatric Insights Advances and Innovations with Children's Health, where we explore the latest in pediatric care and research.

I'm your host, Dr. Bob Underwood. Today we're talking with Dr. Stormee Williams, the Vice President and Chief Health Equity Officer and Board Certified Pediatrician at Children's Health. We're discussing how the health equity team at Children's Health, in collaboration with clinical and non-clinical teams across the system, have developed a standardized social determinants of health screening process to help identify the specific needs of each patient.

 We'll also discuss why it's important to understand and screen for social determinants of health. Welcome, Dr. Williams. Thanks for being on today.

Stormee Williams, MD: Thank you so much for having me.

Host: Yeah, absolutely. So we, we hear a lot about social determinants of health these days. What exactly do we mean when we're talking about social determinants of health?

Stormee Williams, MD: When we hear that term, we're really talking about those non-medical conditions that have an impact on our health and health outcomes. And those conditions are those in which people are born, grow, live, work, play, and age that influence our health and our health outcomes. These conditions can be shaped by economics and social policies and actually have a greater impact, it is believed, than health care alone. So it's really important for us to be mindful of these determinants of health and screen our patients for them as well.

Host: Yeah, absolutely. And so how do social determinants of health impact the overall health of the patients?

Stormee Williams, MD: So when we talk about how they impact, it's really interesting to look at those individual factors, right? So, if I was to tell you that someone's transportation access or access to transportation could have an impact on health, you may not necessarily think that that's relevant, but let's just say that we have a patient who I prescribe a certain medication for their asthma. And I say, it's very important that you take this medicine every day. And the family agrees that it's very important, but unbeknownst to their provider or their physician, they don't have adequate transportation. So although they arranged for a ride to get to the doctor that day, they may not have a way to get to a pharmacy to pick up that prescription.

And so that child's asthma goes untreated and he's more likely to have a negative health outcome. So we're really talking about those types of issues and conditions that aren't necessarily healthcare, but do have a huge impact on our health.

Host: Absolutely true. And, you know, access is one of the words that I think is key in that. So what is the screening process for social determinants of health at Children's Health?

Stormee Williams, MD: Yeah, so it has evolved over the years. We started our journey back in 2018, really just recognizing that we needed to find a way to systematically approach these questions for our families. And so, after many iterations and pilot projects, we landed on a digital solution screening tool. And what that means is that we utilize our patient portal and tablets to ask patients these very specific questions.

And once they are able to self-report those answers, it is fed directly into our electronic health record. So the clinical staff can look at those results, once the family inputs them. And so it's a part of the electronic health record.

Host: Well, it's phenomenal because then it codifies that information. So, why is it important to understand and screen for social determinants of health?

Stormee Williams, MD: Because we are more than the healthcare that we receive and have access to, all of us. And so, our health behaviors, our socioeconomic factors, even our physical environment, all of these things impact how we interact with the healthcare system, but also, have an impact on our health outcomes and how healthy we are overall.

And so if we can screen our patients for them and become aware of the different barriers and the different factors that impact their health, then we just have more tools in our toolkit in addressing those needs. And as physicians, we know that we have a finite amount of time that we are interacting with families, but they go home to those environments that really shape who they are and how healthy they are.

So if we're just more aware of it, it allows us to treat the whole family and the whole patient as best we can.

Host: Yeah, absolutely true. And then, so, what do we know about Children's Health in our community based on this screening and the health equity research? And how is that actually being used to advance health equity?

Stormee Williams, MD: Health equity is needed because there are disparities and disparities are those preventable outcomes in health that we need to be aware of so that we can address them. And social determinants of health is just one of those kind of factors or groups of things that impact health equity. I'm really proud of Children's because several years ago, our CEO signed the pledge for equity that was put out by the American Hospital Association, really saying that not only are we going to have a dedicated leader and team that is really responsible for the work of health equity; but we're going to put our executive leaders and our, our leadership and managerial teams to task, to make sure that they are also aware and keeping their teams abreast of what Children's is doing. So that means that we have a concentrated effort in the community to utilize our community health needs assessment, to know what it is that our families and the communities in which they live, what they need.

 We are extremely intentional in making sure that we are connecting our families with resources in the community so that they can kind of help themselves, if you will, to the different offerings within the community. But then Children's also works with these community based organizations to support them so that we can really partner together to make sure that the community has what it needs. There's a lot of work to do, but I'm really proud of the work that we've done so far.

Host: Yeah, it really sounds like Children's Health is being a community leader in that effort. That's really just phenomenal. So, do you have like community health workers that help with the information and help break down those barriers to care?

Stormee Williams, MD: Yes, so we have a group of what's called our family resource coordinators that function kind of like a community health worker. So they really are our frontline staff in terms of connecting with families after they fill out the survey. And they recognize, the families have recognized that they do have some of the more urgent needs like food insecurity or housing insecurity.

Our family resource coordinators who are kind of like social work extenders, if you will, they reach out to the families to see if they want more dedicated help in getting those resources. And they also have the capability to follow up with them to see if they were able to get the help that they needed.

Host: Well, it's phenomenal that you actually take that information and then actually use it, to do something about it, and I think that that's the key.

Stormee Williams, MD: Absolutely.

Host: Now, you know, you guys started in 2018, now it's becoming a federal requirement to do work around social determinants of health, but you guys really have a step up on the process, so that's wonderful.

Stormee Williams, MD: Yeah, yeah, I'm really proud that again, you know, we want to be not just doers because it is a requirement, but because it's the right thing to do and Children's recognized that several years ago. So it's such a privilege of mine to carry forth on that mission.

Host: Yeah, absolutely true, absolutely. Anything else that you'd like to, like to add before we close?

Stormee Williams, MD: I would just say that social determinants of health is something that's been around for decades. And it's been recognized in philosophy and medicine for years and saying that people's health is so much more than just access to medicine or access to health care and there's even been some great research out there that showed that investing in more social programs and community programs actually can have a more positive benefit on people's health outside of just investing in medicine.

So, when we look at that, we really realize that there's more to a person than just what's right in front of us at that moment. And it allows us to take a look at the broader patient and the broader family and the community in which they come from. So I'm really proud to be a part of this momentum in healthcare, where we're just going beyond those, those small interactions that we have within the walls of the hospital and really extending out into the community.

Host: Well, Dr. Williams, thank you for helping us understand the crucial concept of health equity and how it shapes the well being of our patients.

Stormee Williams, MD: Thank you. It was great talking with you.

Host: You bet. And thanks to our audience for listening to Pediatric Insights, Advances, and Innovations with Children's Health, where we explore the latest in pediatric care and research. You can find more information at Childrens.com, and if you found this podcast helpful, please rate and review or share the episode. And please follow Children's Health on your social channels.