Improving Population Health

Challenge

Our nation suffers staggeringly high and increasing rates of obesity and chronic diseases, compounded by racial and socioeconomic inequities. There is growing awareness that a person’s behavior and social determinants of health — conditions in their environment that affect well-being — have a more significant impact on overall health than clinical care. 

Recent studies estimate that social determinants can be responsible for up to 80 percent of a health outcome. As the Kaiser Family Foundation noted in recent research: “…social factors, including education, racial segregation, social supports, and poverty accounted for over a third of total deaths in the United States in a year.” 

Today, your zip code is a significant indicator of infant mortality and life expectancy. One in five children lacks adequate access to food, often leading to significant health and mental health problems. 

Our Objective

As the United States advances value-based payment methodology, the Health Care program area is building capacity at the state, regional and local level to link government, health, and social services so that Carolinians have the opportunity to increase healthy behaviors and address their social needs.

We seek to connect hospital systems with community-based programs to create healthier communities by increasing the adoption of evidence-based interventions, policies, systems, and environmental changes. With this approach, healthcare providers are supported in implementing community-based programs that create opportunities to change behaviors and address social needs.

What We Fund 

Health Care is partnering with community-based organizations to address social needs such as food insecurity, social isolation, medical-legal partnerships, lifestyle medicine, and health literacy. Recognizing the importance of healthy behaviors, we are interested in advancing programs that help individuals overcome barriers that prevent or limit behavior change. 

At both the state and local levels, we seek to ensure community voice and advance the alignment of community health needs assessments and improvement plans to address population health.