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Utah Governor Spencer Cox Wants To Prioritize Social Determinants to Health Like Income And Housing

The Moab Free Health Clinic Building, Courtesy Moab Free Health Clinic

Having stable income, safe housing, and social support have greater combined impacts on your health than any individual behavior, according to the World Health Organization. And for Utah’s new governor, Spencer Cox, addressing these social determinants to peoples’ health is a priority. From KZMU in Moab, Molly Marcello reports.

You can find the Moab Free Health Clinic between a corner store and a thrift shop on Moab’s west side of town. This unassuming building has become a mainstay for the local community. Hundreds and hundreds of uninsured and underinsured rural Utahans’ pass through its doors each year to access care from staff and medical volunteers.

I’m greeted today by Kolby Williams, the clinic’s community navigation coordinator. The Moab Free Health Clinic is on track to serve a record number of patients in 2021. But this year they’re looking beyond the doctor’s office to do more for public health.

KOLBY WILLIAMS: And so instead of just focusing solely on the medical aspect, which would be like the hospital, us, Green River [Medical Center] – we want to look at, like the conditions people are in. The conditions that are like resulting from poverty, and generational things. And those have such like strong impacts on health.

Williams and the Free Health Clinic are building the Moab Community Referral System. It’s a closed loop, digital system that will connect local medical providers to community aid organizations. It will essentially allow anyone who shows up at the free health clinic or one of their many partner organizations to easily get referrals for social needs like housing and childcare.

WILLIAMS: Which kind of like cuts down the burden on people. Because obviously, if you're struggling to like find something to do with your children on the weekends, it's going to be hard to sign up like 10 different nonprofits, you just don't have the time or like energy to do that.

This referral system, it’s aimed to directly address what’s known as the social determinants of health. According to the World Health Organization, these are the conditions in which people are born, grow, work, and live. And they can have big impacts on our overall health outcomes. The Moab Free Health Clinic knows it, and so does the Governor of Utah.

SPENCER COX: What most people don't understand is that access to health care is actually a fairly small percentage of total health outcomes. It's all these other things, right? Access to healthy food, access to transportation, access to housing – all of these things add up to determine not just how long we'll live, but the type of life that will live.

Within two weeks of assuming his role as Governor this January, Spencer Cox released a list of strategic priorities that would shape his first 500 days in office. Addressing social determinants made that list. He says he became aware of the issue when he chaired a state commission on intergenerational poverty.

For years, Tracy Gruber was the senior advisor to the Intergenerational Poverty Initiative. She’s now the head of the Governor’s health security team. She says data increasingly finds…

TRACY GRUBER: …that if you address the social determinants of health, not only are you going to improve health outcomes for individuals, which then helps them stay connected to school, and connected to work and be successful…But you were also going to improve overall wellbeing for children who were in or at risk of being in the cycle of intergenerational poverty.

And COVID-19 has unequivocally exposed gaps when it comes to these social determinants of health in Utah, according to Governor Cox. At one point during the pandemic, he says Latinos represented as many as half of COVID-19 cases, while making up only about 14 percent of the state’s population. Experts directly related those numbers to social determinants like access to healthcare and work conditions. So Cox says the pandemic…

COX: …exposed in a very big way, kind of with a microscope or a magnifying glass maybe is the better, the better analogy, what's happening out there.

The Governor’s health security team is expected to deliver actionable items to address social determinants in Utah by the end of April.

Moab Free Health Clinic staffer Williams says looking more closely at the root causes of our health outcomes, well, it’s about time. He says it’s been easier for the government and medical community at large to roll out things like federal nutrition programs in schools, but much harder to…

WILLIAMS: …overhaul an entire, like generation of redlining, and all the housing crises that have like popped up all over the country.

That’s why he says healthcare providers need to start working more efficiently with organizations directly addressing social determinants like housing.

Closing the loop on health like this, it’s like pair of arms, folding in around a person. Feeling supported by your community, that’s a social determinant of health too.

In Moab Utah,  I’m Molly Marcello.

KSJD is able to run this story thanks to the Rocky Mountain Community Radio coalition.


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