The November issue of Health Affairs focuses on the “health effects of economic security policies,” including many related to the Coronavirus Aid, Relief, and Economic Security Act. The CARES Act was passed in March 2020 to aid Americans grappling with the early effects of the pandemic. Many of the articles describe programs designed to help patients and consumers engage with non-medical aspects of their lives that greatly affect health.
This may sound like a familiar theme. Two weeks ago, I wrote about Vo+ER, a program that offers information about voter registration to people who come to emergency rooms. The driving principle is to empower people to participate in public policies that affect their health, including things often referred to as “social determinants of health.” Tht article was one in what has become an informal series in this blog.
The November issue of Health Affairs includes Financial Coaching Offers New Paths To A Healthy Future, about a program called StreetCred, a medical-financial partnership with which pediatric practices offer patients and families help with financial and tax planning. That program has also been covered in the New England Journal of Medicine and Engaging Patients.
The issue also includes an article that found expanded access to temporary financial assistance was associated with better mental and physical health and a study of a successful short term incentive program that encouraged grocery shoppers to purchase more fruit, vegetables, nuts, and legumes. It also reports on a study that examined increased use of video telehealth, finding “increases in willingness were especially pronounced among Black adults and adults with lower educational attainment.”
The ongoing Narrative Matters series in Health Affairs focuses on storytelling, often with a personal, inside story told by a clinician, a patient, a relative or friend of someone in care, a teacher, policymaker and others with a role in health care. In the November issue’s Narrative Matters essay, primary care pediatrician Benjamin Danielson describes a family’s multi-generational trauma, based in structural racism, which shows up in real time, on the ward of a hospital in Seattle as refusal or inability to engage with a young patient’s mother with respect and caring. It’s a compelling, devastating story that reveals the deep forces at work in patient engagement.