Iowa Community Health Centers & Social Determinants of Health: A Primer

June 29, 2017

Imagine your typical day.

You wake up in the morning in a home where you feel safe, eat breakfast, and head to work or school in your car, and have a relatively stress free day.

But what if your day wasn’t that simple? You wake up every morning in a shelter. You aren’t sure where your next meal will come from. You don’t have transportation. What if your child has asthma due to your living conditions, or there aren’t any job openings in your town?

For many people factors such as these, also known as Social Determinants, greatly affect not only their lives but their health. Aspects of everyday life that many take for granted are often barriers for others.

The Iowa Primary Care Association and our community health centers have witnessed over the years how social determinants play a role in the health of our patients. By offering enabling services such as transportation to appointments, connecting patients to social services, and providing interpreters, health centers are at the forefront of addressing these factors to improve the health outcomes of our patients through high quality, cost-effective care.

The Iowa PCA is further expanding our work by capturing the social determinants affecting our patients through a patient survey tool, Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE). Developed in conjunction with the National Association of Community Health Association, the Association of Asian Pacific Community Health Organizations, the Oregon Primary Care Association, and the Institute for Alternative Futures, this national effort aims to help health centers and other providers collect data on their patients’ needs and risks to better target both clinical and non-clinical care. Two health centers in Iowa, Siouxland Community Health Center in Sioux City and Peoples Community Health Clinic in Waterloo, were part of a group of pioneer health centers to test PRAPARE and are currently using the tool. Our staff is also in the process of developing plans to expand to more health centers in Iowa.

The Sioux City Journal published last week a great piece about how Siouxland Community Health Center is using PRAPARE to identify and address the basic needs of their patients.

During the past year, we’ve also partnered with Iowa Legal Aid to test a new Medical-Legal Partnership Model between Community Health Centers and attorneys thanks to a grant from the Telligen Community Initiative. Through this model, Certified Application Counselors at Siouxland Community Health Center and Primary Health Care, Inc. in Des Moines, Ames, and Marshalltown, are able to refer consumers whom may have certain legal needs that affect their health to an attorney employed by Iowa Legal Aid.

As we continue this work, we encourage others in Iowa to join our effort to address the needs of Iowa’s vulnerable populations. In the coming months, we will take a deeper dive into the social determinants of health affecting many low-income Iowans and our work to ensure a healthier future for our patients.