Battle Cry: An Interview with Jason Wilson

Battle Cry: An Interview with Jason Wilson

Jason Wilson has been training and mentoring men and speaking about emotional, mental, and spiritual health for decades. His new book Battle Cry shares his insights and principles for becoming the man he is and helping others become the holistically healthy people God has called them to be. UrbanFaith sat down with him to discuss his new book and his journey.

 


About Battle Cry

For decades, Jason Wilson tried his best to “be a man” but struggled to express the full range of human emotions because the only ones he felt comfortable expressing were the traditional “masculine” emotions–anger, aggression, and boldness. This went on until he finally released years of past trauma to attain the healing he needed to become a better man, husband, father, and leader. Learning how to master his emotions and verbally process them transformed Jason’s life and relationships in ways he never could have imagined. He now seeks to expose the lies that many men have been deceived to believe about manhood and bring healing to their lives. Battle Cry will teach men how to wage and win the war within themselves–unlearning society’s definition of masculinity and empowering them with the tools needed to freely live from their hearts instead of their fears.

3 Ways Going Vegan has Helped my Walk with God

3 Ways Going Vegan has Helped my Walk with God

A lot of people are making the switch to becoming vegan, but what does being a vegan have to do with our faith? Here our 3 ways becoming a vegan has helped my walk with God.

  1. Discipline

The reason that I decided to even attempt this wild endeavor in the first place was to get a better grip on my health. If the last two years have taught me anything, it is not to take my time for granted. For as long as I could remember, food was always more than just food to me. It had emotional weight to it, like seeing an old friend for the first time in a long time. Having to learn to eat for a purpose instead of for comfort has probably been the hardest part of this whole transition. Eventually, I accepted that there was no magic bullet that could reconcile these two different views of food. The key to success was discipline, getting up and holding myself accountable to the standard I had set for myself. This has begun to seep into other parts of my life, including my prayer life. Slowly, I’ve noticed it’s easier to get the motivation to do things that aren’t necessarily the most exciting but are important including reading my Bible and praying.

2. A greater appreciation for nature

Another consequence that I have noticed as a result of giving up meat is that I have a greater appreciation for nature. Before, I recognized that much of my diet was directly disconnected from me either through processing or butchering. Since the switch though, I find that I obviously eat a lot more raw fruits and vegetables. As a result, I have to be intentional about what I’m putting in my body which means learning what food contains which vitamins and minerals. I was actually in the grocery store trying to buy some peppers when I realized just how perfectly God built this world for us. Everything we need to live comes from the Earth, nature is a system built to take care of us. Even animals each have their function beyond just food for us, although they often become food for other things. However, what this means is not that we should take these resources for granted, they are special. God commands Adam to look after his creation mere verses after creating him. Nature is not just something to be manipulated for personal gain. It takes care of us and we, in turn, should take care of it. 

3. Greater appreciation for myself

As I said earlier, one of the major motivations for my decision to go vegan is to improve my health. I’ve only been doing this for a few weeks but all of the things vegans say they felt after switching are actually pretty valid. My skin is clearer than it’s been in years, I have a lot more energy, and I’ve actually lost a few pounds too. Perhaps the best change that has happened concerns my relationship with eating. Before the switch, I’d always felt a little guilty after eating something. I’ve never been a small person and that comes with certain hang-ups like being self-conscious about what you put in your body. Since the switch, I haven’t really felt like that. Even when I slip up, I know that I am doing the right thing by getting back on track the next day. That level of self-assurance is nice, it drives me to exercise and to keep going even when I really want to tuck into a juicy rack of ribs. It also just makes me feel more confident in general. Jesus calls loving your neighbor as yourself one of the most important commandments and people tend to latch onto the first part without stopping to consider the second. It’s hard to love your neighbor when you hardly love yourself. I’m not just talking about confidence, but also your physical self. Switching has made me feel like I’m treating my body as a temple for the first time in a long time. I feel more capable of reaching my goals and working to advance God’s kingdom

I didn’t make this piece to win over converts to veganism. If you’re considering it then I think you should give it a try, but the most important goal is to get healthy and stay healthy. Of course, this process is going to vary from person to person but the most important part is the first step. Go for a run, make a meal plan, or just talk about health with your friends and family members. These are all great first steps to a healthier life and you might even learn something on the way. 

“Black people don’t commit suicide. That’s a white thing!”

“Black people don’t commit suicide. That’s a white thing!”

Video Courtesy of AJ+


“Black people don’t commit suicide. That’s a white thing.”

Who said that? That is a false statement. Blacks suffer from mental illness just like their white counterparts. In fact, when you think of everyday stressors, systematic-racism such as police brutality, education and health care gaps, and sexism that impacts black women, blacks are more likely to be at risk for developing a mental condition.

Although July is Minority Mental Health Awareness Month, this week, September 5-11 is National Suicide Prevention Week and it is a perfect time to shed light on what many deem a nonexistent problem. Schizophrenia, post-traumatic stress disorder, bipolar disorder, major depression, generalized anxiety disorder, dissociative identity disorder/multiple personality disorder, bulimia, ADHD, OCD and social anxiety are examples of mental illnesses that people battle daily. In the black community, many choose not to acknowledge mental illness as a sickness. Diseases such as diabetes and cancer are accepted as normal and natural, but what so many fail to realize is that blacks are no different than any other race when it comes to these illnesses. We are not exempt from mental illness.

While some experience mental illness only once in their life (depending on the illness, environment, life stressors, and genetics), others battle mental illness for the rest of their lives. Some of us think that we do not have a problem and truly believe that everyone else is the issue. Unfortunately, these myths and illusions force us to suffer in silence and not seek treatment. Mental illness affects “everyday functional” people and it is not limited to the homeless man talking to himself. It impacts a person’s emotions, perception, and behaviors.

As a person with major depression and generalized anxiety disorders, the comments said to me have been heartbreaking and mind-blowing because it prevented me from seeking help. I thought that I was making it up in my head even though I didn’t feel well for years. Finally diagnosed at 25, my doctor stated that the illness started around the age of 13. Can you imagine having cancer without being diagnosed for over 10 years? You would die. Well, I can tell you that I was dying on the inside and it led to multiple suicide attempts. My illness can get so debilitating. At one point, it stopped me from doing basic things such as going to work, talking, eating and showering.

Here are some of the myths that we must stop saying!

Myth #1: Only white people commit suicide.

Fact: According to by the Centers for Disease Control and Prevention, the suicide rate of black children in between the ages of 5 and 11 doubled between 1993 and 2013  and the rate among white children committing suicide declined. Suicides by hanging nearly tripled among black boys. While whites still have highest suicide rates in the country, suicide rates among black youth have significantly grown over the past decade. Unfortunately, black youth are killing themselves more frequently than their elders. Suicide has become the third leading cause of death among black people between the ages of 15 and 24 and a leading cause of death among school-aged children younger than 12 years in the United States.

Myth #2: Medication doesn’t work and/or they make you feel worse.

Fact: Medication is necessary for some individuals in their mental recovery. While they are NOT cures for mental illness, they are vital for treating the symptoms. Some may need medication for the rest of their lives (depending on the illness) and others only need it for a specific time. Nonetheless, medication is not a sign of weakness and it does not mean the person is crazy. It is no different from taking medication for high blood pressure or insulin for diabetes. Just like the body gets sick, the brain gets sick too, if you don’t take care of it. And no, this is not to say that everyone with a mental illness will need medication, but it is an invaluable help to many.

Myth #3: Black people don’t go to therapy.

Fact: Though there has been a deep-rooted stigma about seeking therapy, Blacks are increasingly seeking therapy for mental illness. Therapy is great whether you have a mental illness or not. Therapy helps you to work on yourself, dissect problems, face fears and overcome obstacles such as breakups, loss of a loved one, financial challenges, self-image issues, abuse, etc. As mentioned previously, blacks deal with oppression daily and therapy can help us work through it. Those who are still hesitant to try therapy can look into other ways of getting help. The support of a life coach has also been shown to be beneficial for many.

Myth #4: You can pray it away.

Fact: As a Christian, I have seen God perform miracles in my life. But when you say to a person “just pray,” you are assuming that they are not praying and dismissing how they feel, challenging the sincerity of their faith, and most likely preventing them from getting treatment. You would not say “just pray” to a person who broke a leg. You would tell them to go to the doctor for an x-ray and cast. We must treat mental illness the same. God also gives us resources to use on earth and sometimes that may be therapy and medication when a person is battling a mental illness.

Damian Waters is a marriage and family therapist in Upper Marlboro, MD, where he serves predominantly African American clients. On the issue of the stigma surrounding blacks seeking therapy, he says, “There’s some shame and embarrassment. You’ll tell someone that you went to the doctor, but you won’t tell that you went to the counselor or psychiatrist. Also, there is the idea that their faith should carry them through, though often their problems are larger than that.”

As a way to honor those with mental illness, please think before you speak, and encourage those who need help to seek treatment. Mental illness is just as serious as any other disease and those affected by it should not be judged or outcast. Mental illness is a flaw in brain chemistry, not a character flaw, or a white people problem.

 

Can you think of other myths surrounding Blacks and mental illness? Share them below along with your thoughts on putting the myths to rest once and for all.

With more than a million children orphaned by COVID, faith-based groups look to mobilize support

With more than a million children orphaned by COVID, faith-based groups look to mobilize support

(RNS) — More than a million children around the world may have been orphaned by COVID-19, losing one or both parents to the disease or related causes.

Another estimated 500,000 lost a grandparent or another relative who cared for them.

The numbers are from a new study by researchers from the U.S. Centers for Disease Control and Prevention and others that highlight another grim reality in the sweeping devastation caused by the ongoing pandemic.

“These new estimates highlight the tremendous impact COVID-19 has had on children around the world,” said Elli Oswald, executive director of the Faith to Action Initiative.

Members of the Faith to Action Initiative, a coalition of faith-based child welfare organizations that includes Bethany Christian Services, World Vision and other nonprofits and ministries, responded this week to the study published Tuesday (July 20) in The Lancet, encouraging Christians to mobilize to care for those children and support surviving family members.

“We know when families are supported during these tragic times, they can provide the love and care a child needs to thrive. The church is best placed to respond to the needs of these children as it carries out the vision we see in scripture of God’s intention for family, and ensures that a child never needs to be placed in an orphanage,” Oswald said.

Researchers from the CDC, the U.S. Agency for International Development, the World Bank and the University College London used COVID-19 mortality data from March 2020 through April 2021 and national fertility statistics for 21 countries to offer the first global estimates of the number of children orphaned by the disease.

Their methods were similar to those used by the UNAIDS Reference Group on Estimates, Modelling and Projections to estimate the number of children orphaned by AIDS.

“Orphanhood and caregiver deaths are a hidden pandemic resulting from COVID-19-associated deaths,” according to the study.

Children who have lost a parent or caregiver are at increased risk for disease, physical abuse, sexual violence and adolescent pregnancy, according to a press release accompanying the study. They also risk being separated from their families and placed in orphanages or care homes, which researchers say have been linked to negative effects on social, physical and mental development.

The solution, said Chris Palusky, president and CEO of Bethany Christian Services, is “the loving care of a family, not another orphanage.” He pointed to Scripture passages that say God sets the lonely in families and call on Christians to care for those who have been orphaned.

“We urge Christians to support efforts to strengthen vulnerable families and communities, reunify families, and place children without caregivers in loving families, so that children never have to live in orphanages,” Palusky said.

Losing a loved one and caring for orphaned children also puts “immense” stress on remaining parents and extended family members, added Margaret Schuler, World Vision’s senior vice president of international programs.

“Yet efforts for care must be focused at supporting them in and through their families to prevent unnecessary separation,” Schuler said. “We encourage Christians and the Church to mobilize to keep families together in order to help children thrive.”

The study was published alongside a report by the CDC and other agencies titled ” Children: The Hidden Pandemic 2021.”

 

With Roots in Civil Rights, Community Health Centers Push for Equity in the Pandemic

With Roots in Civil Rights, Community Health Centers Push for Equity in the Pandemic

In the 1960s, health care across the Mississippi Delta was sparse and much of it was segregated. Some hospitals were dedicated to Black patients, but they often struggled to stay afloat. At the height of the civil rights movement, young Black doctors launched a movement of their own to address the care disparity.

“Mississippi was third-world and was so bad and so separated,” said Dr. Robert Smith. “The community health center movement was the conduit for physicians all over this country who believed that all people have a right to health care.”

In 1967, Smith helped start Delta Health Center, the country’s first rural community health center. They put the clinic in Mound Bayou, a small town in the heart of the Delta, in northwestern Mississippi. The center became a national model and is now one of nearly 1,400 such clinics across the country. These clinics, called federally qualified health centers, are a key resource in Mississippi, Louisiana and Alabama, where about 2 in 5 people live in rural areas. Throughout the U.S., about 1 in 5 people live in rural areas.

The covid-19 pandemic has only exacerbated the challenges facing rural health care, such as lack of broadband internet access and limited public transportation. For much of the vaccine rollout, those barriers have made it difficult for providers, like community health centers, to get shots into the arms of their patients.

“I just assumed that [the vaccine] would flow like water, but we really had to pry open the door to get access to it,” said Smith, who still practices family medicine in Mississippi.

Mound Bayou was founded by formerly enslaved people, many of whom became farmers.

The once-thriving downtown was home to some of the first Black-owned businesses in the state. Today the town is dotted with shuttered or rundown banks, hotels and gas stations.

Mitch Williams grew up on a Mound Bayou farm in the 1930s and ’40s and spent long days working the soil.

“If you would cut yourself, they wouldn’t put no sutures in, no stitches in it. You wrapped it up and kept going,” Williams said.

When Delta Health Center started operations in 1967, it was explicitly for all residents of all races — and free to those who needed financial help.

Williams, 85, was one of its first patients.

“They were seeing patients in the local churches. They had mobile units. I had never seen that kind of comprehensive care,” he said.

Residents really needed it. In the 1960s, many people in Mound Bayou and the surrounding area didn’t have clean drinking water or indoor plumbing.

At the time, the 12,000 Black residents of northern Bolivar County, which includes Mound Bayou, faced unemployment rates as high as 75% and lived on a median annual income of just $900 (around $7,500 in today’s dollars), according to a congressional report. The infant mortality rate was close to 60 for every 1,000 live births — four times the rate for affluent Americans.

Delta Health Center employees helped people insulate their homes. They built outhouses and provided food and sometimes even traveled to patients’ homes to offer care, if someone didn’t have transportation. Staffers believed these factors affected health outcomes, too.

Williams, who later worked for Delta Health, said he’s not sure where the community would be today if the center didn’t exist.

“It’s frightening to think of it,” he said.

Half a century later, the Delta Health Center continues to provide accessible and affordable care in and around Mound Bayou.

Black Southerners still face barriers to health. In April 2020, early in the pandemic, Black residents accounted for nearly half of covid deaths in Alabama and over 70% in Louisiana and Mississippi.

Public health data from last month shows that Black residents of those states have consistently been more likely to die of covid than residents of other races.

“We have a lot of chronic health conditions here, particularly concentrated in the Mississippi Delta, that lead to higher rates of complications and death with covid,” said Nadia Bethley, a clinical psychologist at the center. “It’s been tough.”

Delta Health Center has grown over the decades, from a few trailers in Mound Bayou to a chain of 18 clinics across five counties. It’s managed to vaccinate over 5,500 people against covid. The majority have been Black.

“We don’t have the National Guard, you know, lining up out here, running our site. It’s the people who work here,” Bethley said.

The Mississippi State Department of Health said it has prioritized health centers since the beginning of the rollout. But Delta Health CEO John Fairman said the center was receiving only a couple of hundred doses a week in January and February. The supply became more consistent around early March, center officials said.

“Many states would be much further ahead had they utilized community health centers from the very beginning,” Fairman said. Fairman said his center saw success with vaccinations because of its long-standing relationships with the local communities.

“Use the infrastructure that’s already in place, that has community trust,” said Fairman.

That was the entire point of the health center movement in the first place, said Smith. He said states that were slow to use health centers in the vaccine rollout made a mistake that has made it difficult to get a handle on covid in the most vulnerable communities.

Smith called the slow dispersal of vaccines to rural health centers “an example of systemic racism that continues.”

A spokesperson for Mississippi’s health department said it is “committed to providing vaccines to rural areas but, given the rurality of Mississippi, it is a real challenge.”

Alan Morgan, CEO of the National Rural Health Association, said the low dose allocation to rural health clinics and community health centers early on is “going to cost lives.”

“With hospitalizations and mortality much higher in rural communities, these states need to focus on the hot spots, which in many cases are these small towns,” Morgan said of the vaccine efforts in Mississippi, Louisiana and Alabama.

A report from KFF found that people of color made up the majority of people vaccinated at community health centers and that the centers seem to be vaccinating people at rates similar to or higher than their share of the population. (The KHN newsroom, which collaborated to produce this story, is an editorially independent program of KFF.)

The report added that “ramping up health centers’ involvement in vaccination efforts at the federal, state and local levels” could be a meaningful step in “advancing equity on a larger scale.”

Equal access to care in rural communities is necessary to reach the most vulnerable populations and is just as critical during this global health crisis as it was in the 1960s, according to Smith.

“When health care improves for Blacks, it will improve for all Americans,” Smith said.

This story is from a partnership that includes NPR, KHN and the three stations that make up the Gulf States Newsroom: Mississippi Public Broadcasting; WBHM in Birmingham, Alabama; and WWNO in New Orleans.

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Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

Hospitals, Insurers Invest Big Dollars to Tackle Patients’ Social Needs

PHILADELPHIA — When doctors at a primary care clinic here noticed many of its poorest patients were failing to show up for appointments, they hoped giving out free rides would help.

But the one-time complimentary ride didn’t reduce these patients’ 36% no-show rate at the University of Pennsylvania Health System clinics.

“I was super surprised it did not have any effect,” said Dr. Krisda Chaiyachati, the Penn researcher who led the 2018 study of 786 Medicaid patients.

Many of the patients did not take advantage of the ride because they were either saving it for a more important medical appointment or preferred their regular travel method, such as catching a ride from a friend, a subsequent study found.

It was not the first time that efforts by a health care provider to address patients’ social needs — such as food, housing and transportation — failed to work.

In the past decade, dozens of studies funded by state and federal governments, private hospitals, insurers and philanthropic organizations have looked into whether addressing patients’ social needs improves health and lowers medical costs.

But so far it’s unclear which of these strategies, focused on so-called social determinants of health, are most effective or feasible, according to several recent academic reports by experts at Columbia, Duke and the University of California-San Francisco that evaluated existing research.

And even when such interventions show promising results, they usually serve only a small number of patients. Another challenge is that several studies did not go on long enough to detect an impact, or they did not evaluate health outcomes or health costs.

“We are probably at a peak of inflated expectations, and it is incumbent on us to find the innovations that really work,” said Dr. Laura Gottlieb, director of the UCSF Social Interventions Research and Evaluation Network. “Yes, there’s a lot of hype, and not all of these interventions will have staying power.”

With health care providers and insurers eager to find ways to lower costs, the limited success of social-need interventions has done little to slow the surge of pilot programs — fueled by billions of private and government dollars.

Paying for Health, Not Just Health Care

Across the country, both public and private health insurance programs are launching large initiatives aimed at improving health by helping patients with unmet social needs. One of the biggest efforts kicks off next year in North Carolina, which is spending $650 million over five years to test the effect of giving Medicaid enrollees assistance with housing, food and transportation.

California is redesigning its Medicaid program, which covers nearly 14 million residents, to dramatically increase social services to enrollees.

These moves mark a major turning point for Medicaid, which, since its inception in 1965, largely has prohibited government spending on most nonmedical services. To get around this, states have in recent years sought waivers from the federal government and pushed private Medicaid health plans to address enrollees’ social needs.

The move to address social needs is gaining steam nationally because, after nearly a dozen years focused on expanding insurance under the Affordable Care Act, many experts and policymakers agree that simply increasing access to health care is not nearly enough to improve patients’ health.

That’s because people don’t just need access to doctors, hospitals and drugs to be healthy, they also need healthy homes, healthy food, adequate transportation and education, a steady income, safe neighborhoods and a home life free from domestic violence — things hospitals and doctors can’t provide, but that in the long run are as meaningful as an antibiotic or an annual physical.

Researchers have known for decades that social problems such as unstable housing and lack of access to healthy foods can significantly affect a patient’s health, but efforts by the health industry to take on these challenges didn’t really take off until 2010 with the passage of the ACA. The law spurred changes in how insurers pay health providers — moving them away from receiving a set fee for each service to payments based on value and patient outcomes.

As a result, hospitals now have a financial incentive to help patients with nonclinical problems — such as housing and food insecurity — that can affect health.

Temple University Health System in Philadelphia launched a two-year program last year to help 25 homeless Medicaid patients who frequently use its emergency room and other ERs in the city by providing them free housing, and caseworkers to help them access other health and social services. It helps them furnish their apartments, connects them to healthy delivered meals and assists with applications for income assistance such as Social Security.

To qualify, participants had to have used the ER at least four times in the previous year and had at least $10,000 in medical claims that year.

Temple has seen promising results when comparing patients’ experiences before the study to the first five months they were all housed. In that time, the participants’ average number of monthly ER visits fell 75% and inpatient hospital admissions dropped 79%.

At the same time, their use of outpatient services jumped by 50% — an indication that patients are seeking more appropriate and lower-cost settings for care.

Living Life as ‘Normal People Do’

One participant is Rita Stewart, 53, who now lives in a one-bedroom apartment in Philadelphia’s Squirrel Hill neighborhood, home to many college students and young families.

“Everyone knows everyone,” Stewart said excitedly from her second-floor walk-up. It’s “a very calm area, clean environment. And I really like it.”

Before joining the Temple program in July and getting housing assistance, Stewart was living in a substance abuse recovery home. She had spent a few years bouncing among friends’ homes and other recovery centers. Once she slept in the city bus terminal.

In 2019, Stewart had visited the Temple ER four times for various health concerns, including anxiety, a heart condition and flu.

Stewart meets with her caseworkers at least once a week for help scheduling doctor appointments, arranging group counseling sessions and managing household needs.

“It’s a blessing,” she said from her apartment with its small kitchen and comfy couch.

“I have peace of mind that I am able to walk into my own place, leave when I want to, sleep when I want to,” Stewart said. “I love my privacy. I just look around and just wow. I am grateful.”

Stewart has sometimes worked as a nursing assistant and has gotten her health care through Medicaid for years. She still deals with depression, she said, but having her own home has improved her mood. And the program has helped keep her out of the hospital.

“This is a chance for me to take care of myself better,” she said.

Her housing assistance help is set to end next year when the Temple program ends, but administrators said they hope to find all the participants permanent housing and jobs.

“Hopefully that will work out and I can just live my life like normal people do and take care of my priorities and take care of my bills and things that a normal person would do,” Stewart said.

“Housing is the second-most impactful social determinant of health after food security,” said Steven Carson, a senior vice president at Temple University Health System. “Our goal is to help them bring meaningful and lasting health improvement to their lives.”

Success Doesn’t Come Cheap

Temple is helping pay for the program; other funding comes from two Medicaid health plans, a state grant and a Pittsburgh-based foundation. A nonprofit human services organization helps operate the program.

Program organizers hope the positive results will attract additional financing so they can expand to help many more homeless patients.

The effort is expensive. The “Housing Smart” program cost $700,000 to help 25 people for one year, or $28,000 per person. To put this in perspective, a single ER visit can cost a couple of thousands of dollars. And “frequent flyer” patients can tally up many times that in ER visits and follow-up care.

If Temple wants to help dozens more patients with housing, it will need tens of millions of dollars more per year.

Still, Temple officials said they expect the effort will save money over the long run by reducing expensive hospital visits — but they don’t yet have the data to prove that.

The Temple program was partly inspired by a similar housing effort started at two Duke University clinics in Durham, North Carolina. That program, launched in 2016, has served 45 patients with unstable housing and has reduced their ER use. But it’s been unable to grow because housing funding remains limited. And without data showing the intervention saves on health care costs, the organizers have been unable to attract more financing.

Often there is a need to demonstrate an overall reduction in health care spending to attract Medicaid funding.

“We know homelessness is bad for your health, but we are in the early stages of knowing how to address it,” said Dr. Seth Berkowitz, a researcher at the University of North Carolina-Chapel Hill.

Results Remain to Be Seen

“We need to pay for health not just health care,” said Elena Marks, CEO of the Houston-based Episcopal Health Foundation, which provides grants to community clinics and organizations to help address the social needs of vulnerable populations.

The nationwide push to spend more on social services is driven first by the recognition that social and economic forces have a greater impact on health than do clinical services like doctor visits, Marks said. A second factor is that the U.S. spends far less on social services per capita compared with other large, industrialized nations.

“This is a new and emerging field,” Marks said when reviewing the evaluations of the many social determinants of health studies. “The evidence is weak for some, mixed for some, and strong for a few areas.”

But despite incomplete evidence, Marks said, the status quo isn’t working either: Americans generally have poorer health than their counterparts in other industrialized countries with more robust social services.

“At some point we keep paying you more and more, Mr. Hospital, and people keep getting less and less. So, let’s go look for some other solutions” Marks said.

The covid-19 pandemic has shined further light on the inequities in access to health services and sparked interest in Medicaid programs to address social issues. Over half of states are implementing or expanding Medicaid programs that address social needs, according to a KFF study in October 2020. (The KHN newsroom is an editorially independent program of KFF.)

The Medicaid interventions are not intense in many states: Often they involve simply screening patients for social needs problems or referring them to another agency for help. Only two states — Arizona and Oregon — require their Medicaid health plans to directly invest money into pilot programs to address the social problems that screening reveals, according to a survey by consulting firm Manatt.

The Centers for Medicare & Medicaid Services, which is funding a growing number of efforts to help Medicaid patients with social needs, said it “remains committed” to helping states meet enrollees’ social challenges including education, employment and housing.

On Jan. 7, CMS officials under the Trump administration sent guidance to states to accelerate these interventions. In May, under President Joe Biden, a CMS spokesperson told KHN: “Evidence indicates that some social interventions targeted at Medicaid and CHIP beneficiaries can result in improved health outcomes and significant savings to the health care sector.”

The agency cited a 2017 survey of 17 state Medicaid directors in which most reported they recognized the importance of social determinants of health. The directors also noted barriers to address them, such as cost and sustainability.

In Philadelphia, Temple officials now face the challenge of finding new financing to keep their housing program going.

“We are trying to find the magic sauce to keep this program running,” said Patrick Vulgamore, project manager for Temple’s Center for Population Health.

Sojourner Ahebee, health equity fellow at WHYY’s health and science show, “The Pulse,” contributed to this report.

This story is part of a partnership that includes WHYY, NPR and KHN.

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