How can healthcare leaders go beyond meeting patient needs to address social determinants of health, especially as COVID-19 reveals the impact of not addressing societal issues like housing, food security, and racism? And should it be their job to tackle these community-wide issues?

Brian C. Castrucci, DrPH, President and CEO of the de Beaumont Foundation, spoke with Kadesha Smith, host of Modern Healthcare’s “Next Up” podcast, about the intersection of healthcare, the social determinants of health, and COVID-19. Listen to the full episode here, see highlights below, or read the transcript.


COVID-19 and the Social Determinants:

“COVID-19 has finally forced us to confront what we’ve been ignoring for a very long time — definitely race, income, and education, but also housing security, food security, gender disparities, and more. We have known about these disparities, we have not done anything to really address them. And now we’re paying a very high price.”

Public Health as a Community’s Foundation:

“Ultimately, public health works against some of the basic ethos of Americana, of everything is individual. It’s me pulling myself up by the bootstraps, and I will forge everything myself. And that’s just not realistic when you live in a society.

“So what we have to help people understand is that public health is like the foundation of your house. It’s not something you think about all that often until it cracks. And right now, with COVID, we’re seeing all the cracks. When that foundation fails, you have to make some choices.

“If you want to have good test scores in school, you need to be healthy. If you want people to do their best job at work, they need to be healthy. If you want people to show up to church on Sunday, they’ve got to be healthy. There’s nothing that you can do in our society if you are not healthy. And so we have to not talk to ourselves about public health, but talk to other leaders and help them understand the value and importance of public health.

Investing in Public Health:

“Right now is a prime opportunity to leverage what’s happened with COVID. We have to help people understand that if we don’t correct the public health system, the vulnerabilities that existed for COVID will continue to perpetuate. We are actually cutting public health workers in some jurisdictions right now at the height of this pandemic. Because the cities don’t have the tax base that they previously had.

“We have to invest in public health. Our public health workers are our frontline — even before the healthcare frontline workers — and we need to support them better. We would never send soldiers into a battle without the tools they needed to win. But that’s precisely what we’ve done with COVID and our healthcare, and our public health workforce.”

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