By Jessica Johnson
Imagine a young woman, six months pregnant, sitting in a waiting room at the doctor’s office. She should be glowing, excited about the impending arrival of her child. Instead, she is anxious. Despite diligently attending all her prenatal check-ups, she remains underweight. Her doctor, concerned about the baby’s growth, gently urges her to focus on nutrition. But what the doctor doesn’t know is that she has been forced to make impossible choices—cutting back on groceries to pay her rent and keep a roof over her head. Her prenatal care is excellent, yet she and her unborn child are at risk. The missing piece? Affordable, nutritious food.
This young mother’s story is not unique. It is the reality for millions of Americans who, despite having access to healthcare, struggle with the basic necessities that are crucial to their health—like food, housing, and safe environments. Healthcare providers can only do so much when they are unaware of the underlying causes of poor health that continue to remain unaddressed. A mother can receive all the prenatal check-ups in the world, but what good are they if she’s forced to eat poorly because nutritious food is out of reach?
This problem highlights the limitations of a healthcare system that focuses on treating symptoms rather than acknowledging and preventing the conditions that lead to poor health in the first place. Healthcare providers, however, cannot help their patients unless they first know about and can recognize these non-medical factors and the impact on their patients. As such, a crucial step in the fight for health equity must take place: educating future healthcare professionals on the social determinants of health (SDOH).
The SDOH are the conditions in which people are born, grow, work, live, and age. These factors, such as income, education, and the physical environment, profoundly impact health outcomes. Asthma medication might control a child’s symptoms, but it cannot repair the mold-infested apartment that triggers their attacks. Antidepressants may help a patient manage their depression, but they can’t mend the isolation caused by a lack of internet access in an increasingly digital world. Prenatal check-ups can help detect pregnancy issues, but they cannot ultimately address the mother’s nutritional risk. This impact of the SDOH culminates in the fact that the United States spends more money on health care than any other highly industrialized country but continues to have some of the poorest health outcomes.
As such, although access to health care is important, it is clear that health is driven by many factors outside of the doctor’s office–living conditions, economic status, education level, access to healthy foods, and more. These all ultimately have a great influence on the health of every pregnant woman in a waiting room. It is critical that healthcare providers understand the extent to which health is shaped by conditions beyond medicine and what it will take to help every patient lead a healthier life.
This is where organizations like Link Health come in. Link Health is uniquely positioned within healthcare settings to identify patients in need and assist them in enrolling in essential federal benefit programs, which specifically target the SDOH, such as the Supplemental Nutrition Assistance Program (SNAP) that provides financial assistance to help families purchase groceries. Link Health’s approach is particularly impactful, as it integrates future healthcare professionals into this work. Many of Link Health’s fellows and ambassadors, who are specially trained to enroll patients in these federal programs, are pre-med students or current medical students. By engaging these future providers in work that directly addresses the SDOH, Link Health is bridging the gap between the medical and public health fields.
Meera, a Link Health fellow at one of the Boston clinics and a current pre-med student at Northeastern University, speaks to the impact of her work. “We screen patients and explicitly ask about the social determinants of health. The eligibility questions cover everything from income to housing status to race and ethnicity. This experience is invaluable for understanding how these factors directly impact health. It’s one thing to learn about social determinants in a classroom; it’s another to see their effects on real patients.” Meera’s work is part of the broader effort to ensure that the next generation of healthcare professionals are not only aware of the SDOH but are equipped to recognize their impact and address them in their future practice.
Through partnerships with local community health centers, Link Health and their team of fellows and ambassadors have supported thousands of families and individuals, ensuring that they receive the assistance for which they rightfully qualify. This work is not just about filling out forms; it’s about making sure that a pregnant mother does not have to choose between feeding herself and paying rent, about ensuring that a child with asthma is not forced to live in a home that makes them sick, about helping people live healthier lives. To date, Link Health has screened over 18,000 patients for federal benefit eligibility and helped distribute over $1.7 million back to low-income families. These are not just numbers; they represent real improvements in health and well-being for some of the most vulnerable members of our society.
The work of Link Health and its centering of future healthcare providers in the heart of such efforts should serve as a model for future initiatives. By bridging this gap between the medical and public health fields, healthcare professionals can be better educated and equipped with the skills necessary to consider all factors–both medical and social–impacting their patients’ health. It is only by addressing these root causes of poor health that we can hope to prevent them in the first place. The health of our nation depends on it.
Author: Jessica Johnson
