As the COVID-19 crisis unfolds, scientists are struggling to understand why two healthy adults with no underlying health conditions can contract the virus, and one may have a mild cough while the other lies in a hospital ICU on a ventilator. Health officials at the CDC are less surprised that some racial and ethnic minority groups are at an increased risk for getting sick and dying from COVID-19.
The pandemic has brought to light long-standing social and health inequities in our country, which increase a person’s risk for disease of any kind as well as morbidity. A 2007 study in the New England Journal of Medicine revealed that over 80 percent of our nation’s health crises are a result of one’s behavior, environment and social causes — also known as social determinants of health (SDOH).
One of the most promising solutions for health equity comes from an unlikely source — technology. Entrepreneurs such as Dr. Mintu Bachann and his team at c3s.org have developed an SDOH app, recently released in several cities. Acting as care management software, C3S changes the way people get help — bridging the gap between patient, healthcare and social care.
“The key to C3S is that it enables the necessary partnerships between schools, social workers, healthcare providers, community health clinics, churches and nonprofits,” explains Bachann. “They can communicate more efficiently, identify people’s needs, better track people’s progress, and identify trends within a community.”
The root problem is more poverty than race, but a higher percentage of minorities are considered low socioeconomic status. According to the American Academy of Pediatrics, 17.9 percent of non-Hispanic white children were living in poverty in 2014, as opposed to 37.1 percent of black children and 31.9 percent of Hispanic children.
Economically stressed children have higher rates of chronic illness, hospital admissions, and mortality. This risk only increases as they become adults. But achieving health equity requires a holistic approach. Safe and affordable housing, education and public safety are just as important as access to healthy foods, quality medical care and environments free of toxins.
“Investments in medical care will fall short without the partnership of social care,” says Bachann. “As Dr. Richard Cooper said, ‘Treating a homeless man’s frostbitten toes is surely a waste, when a pair of shoes could have prevented it.’ Early intervention could ultimately save lives, not to mention billions of dollars in healthcare.”
Acting as a care coordination system, C3S allows doctors to refer patients to food pantries, case workers to refer clients to mental health professionals, and churches to partner together to leverage their impact. Referrals within the app take seconds. Anyone can search the localized database by keyword, then securely send a person’s information via a HIPAA-compliant share feature. All progress is tracked within the dashboard, so patients and providers are all on the same page.
Another key to C3S is that it helps practitioners better understand root-cause issues, which is a challenge in the limited time providers have with each patient. A doctor can treat the asthma or set a broken bone, but it won’t solve the poor housing conditions or abuse that caused it.
Using AI analytics, the C3S intake process generates resilience scores, current ACEs and a future health risk score. ACEs (adverse childhood events) include things like neglect, divorce, an incarcerated family member or abuse (physical, emotional or sexual).
Over time the toxic stress ACEs produce can literally change a person’s epigenetics and brain structure, causing decreased volume in certain regions such as the prefrontal cortex. The stress from COVID-19 only adds fuel to the fire.
“There certainly is an urgency to get this technology into people’s hands in light of the Covid-19 pandemic,” says Bachann. “Treating the trifecta of poverty, the pandemic and ACEs will require a virtual app like C3S. We can possibly turn the tide by automating the social and health care process, making it more efficient to serve more people.”