Washington Health Organizations Launch Projects to Improve Residents’ Health by Mitigating Social Determinants – State of Reform

The social determinants of health have a significant impact on the overall health of Washington residents, and several health organizations are working on projects that aim to improve the effects they can have on residents.

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Alison Poulsen, Leah Becknell, Alison Krutsinger, and Robert DeGregorio discussed some of these projects during the “Innovative Approaches to Addressing the Social Determinants of Health” panel at Conference on reformed health policy in the interior of the northwestern part of the country.

De Gregorio, lead organizer at Spokane Health Equity Circle, said access to education, work environment, health services and housing are social determinants that impact health.

“Also, we have cultural conditions,” DeGregorio said. “That’s where you see, a lot of times, racism, homophobia, all these ‘isms’ and how [they] affect that individual. What’s really important to us is finding innovative approaches to targeting [those] areas. And one of the biggest things is how do we find the social determinant that we have the power to change?

Health Equity Circle members are working to expand the number of languages ​​written on prescription drugs. They began to focus on the problem when members visited a Hispanic household and discovered that a family member was taking much higher doses of medication than prescribed because they could not read their prescription. That person ended up in the emergency room due to an overdose, DeGregorio said.

Team members worked with legislators on the issue, leading to the introduction of House Bill 1852. The bill would have required the Pharmacy Quality Assurance Commission to adopt rules establishing additional requirements for the translation of prescription drug labels and other prescription information, but it did not pass during the last legislative session.

“We didn’t necessarily think it was going to go; we hoped it would,” Degregorio said. “But it’s so important to normalize the idea; to get support behind him and build strength to make that change. Even though it got stuck in committee, we had a lot of people testify before the House and Senate. We had a lot of people show support for it.

Becknell, director of account management at Beacon Health Options, discussed a pilot project Beacon is conducting that is placing Narcan vending machines in rural north-central Washington, including Douglas County.

“Our goal was to increase low-barrier access to overdose reversal medications, specifically Narcan,” Becknell said. “What we did was look for opportunities to stock these Narcan vending machines in very strategic locations in the region. We see a lot of variation around whether or not naloxone is available to individuals who may need it. It is undercharged in many places, especially in minority neighborhoods. And we know about pharmacy deserts in rural areas.

There’s also a lot of stigma attached to people asking for Narcan at pharmacies, Becknell said.

“So even if it’s free and available, people just don’t go out and get it,” Becknell said. “And we really wanted to fulfill that harm reduction principle of trying to meet people where they are and when they might need it.” We used substance abuse funding and block grants or federal block grants to be able to do this.

Becknell said Becknell and his partners distributed almost 800 Narcan kits in the program’s first 6 months of operation.

“There’s definitely a demand for them,” Becknell said. “We can trace 39 lives that were saved by the Narcan we gave out in just the first 6 months. We are looking to expand this and have machines in the South West region where we will put 5 machines. And we’re actively working to put a number of machines in Pierce County as well.”

Poulsen, executive director of Better Health Together, said the organization recently worked with the Newport School District to create a health care clinic for students.

“And they have a delivery person that comes in 2 or 3 times a week,” Poulsen said. “It was great to get some relief from the school nurse covering K to 12. It led to much more regular care for the kids.”

Krutsinger is the director of government affairs and community engagement for the Department of Children, Youth and Families (DCYF), a state agency that focuses on child welfare.

“A lot of systems have failed the families that ended up at our door,” Kruzinger said. “Educational systems, economic systems and housing systems have failed families. Disproportionally BIPOC families and families [with] lower incomes. Why do families end up in the child welfare system, in the juvenile justice system? And how do we really move up and start preventing problems that are really all about our social determinants of health?”

About 70-80 percent of the youth served by DCYF have prior involvement with child welfare, Kruzinger said. Many leave the juvenile justice system and try to re-enter their communities.

“We have expanded and introduced housing specialists and housing vouchers as we think about meeting the needs of young people in partnership with housing organizations,” Kruzinger said. “Another part of the innovation is that we ran an agency to offer an alternative to imprisonment, the so-called Community Transition Services. Most are really young people giving back to their community.

How can we help this transition happen sooner? And one of the questions we were thinking about was how do we make sure that communities are ready so that young people can come back and be successful? So we’ve had a really slow build and rollout of this, but we’ve done some pretty intense work over the last couple of years looking at case profiles and customer studies. Now you’ll see us start asking for the next set of resources to help build the service.”

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