Giving Compass' Take:

• Medical-legal partnerships could help the most vulnerable people receive care if doctors understand and take into account the social determinants of health. 

• Some physicians are developing innovative solutions to get more patients to talk about the social factors that disrupt their health.  How would medical-legal partnerships help bring more trust into communities so that everyone can feel comfortable discussing these factors?

• Read about why social determinants of health are difficult to record in electronic health records. 

The things we generally view as determinants of health—genetics, personal choices, and access to high-quality care—really only play a supporting role. In fact, social, economic and environmental factors determine as much as 60% of an individual’s health status.

Those factors can make it difficult for vulnerable populations to improve their health, but with the help of medical-legal partnerships (MLPs), it’s not impossible, according to presenters at the Public Health Law Conference on Friday.

MLPs give legal and community-based professionals a voice in the healthcare realm, paving the way to remedy health disparities through civil law.

A new study in Health Affairs highlighted evidence that links income to morbidity and mortality. Poor health also leads to lower income, which creates a "negative feedback loop."

But physicians are “not paid to think about the social determinants and to ask about the social determinants,” Hseih said. Although that’s starting to change, he advocated incorporating social factors into a quality metric or as a requirement for reimbursement.

Despite the high need for MLPs, providers often operate on limited budgets and serve a broad geographical area. LA County’s MLP and Health Forward/Salud Aledante, an MLP in the Chicago area, have devised innovative solutions to reach the most people possible in spite of these challenges.

LA County uses a telehealth-esque approach by accepting referrals, meeting with clients and speaking with community partners online and via phone (in addition to in-person). They also provide legal technical assistance to community-based staff to build capacity.

Read the full article about valuing the social determinants of health by Rose Meltzer at Healthcare News