Helping Brazil's Poor Heal at Home

The United States now has a variety of federally-supported nutrition programs, but the health care system remains disconnected from the social determinants of health. Many doctors simply lack the resources to provide the comprehensive care proven to have greater impact on health than strictly medical treatment. A group called Health Leads is training young volunteers to treat the social factors, like poor nutrition and housing needs.

Maryland's health care system is based on three pillars – all-payer rate setting, a global budget, and total cost of care – that, together, have shown positive results both for the patients and for the state's hospitals. Although evidence of success with regard to health care costs is limited, the model of incentiving investment in community health and preventive care has shown success in reducing readmission rates for hospitals across the state.

Building networks of physicians in rural areas helps reduce shortages of healthcare specialists. A partnership between Washington, Wyoming, Alaska, Idaho, and Montana, known collectively as WWAMI, brings doctors to the Northwestern states by offering tuition waivers to doctors who train and remain in rural communities. The program is based out of the University of Washington’s Medical School and connects students with clinics across the partnering states.

Rwanda is a poor, rural country with a troubled history. Yet the country has built an effective national health system by tackling the diseases of poverty, such as diarrhea and pneumonia, with smart use of international aid and local health workers.

New Mexico’s veterans are getting faster care as new programs expand to rural areas. Thanks to a host of initiatives, including telemedicine, contracts with community clinics, and travel benefits, the state’s VA health care system has recently seen improvements in appointment wait times for veterans.

Health insurance sign-ups made available to all inmates at the San Francisco county jail, partnered with guidance from a clinic once they are on the outside, allows them to receive better care upon release, and may help prevent a return to crime and substance abuse.

The Taimaka Outpatient Clinic operates a community-based malnutrition treatment model that brings severe acute malnutrition care closer to families. Since 2019, Taimaka has treated over 12,000 children and currently cares for more than 10,000 children annually.

InSHAPE provides access to tailored health and fitness programs for people living with serious mental illnesses, helping them quit drinking and smoking, learn about nutrition and build a sense of community through gym memberships and workout groups. InSHAPE has been operating for 20 years, and studies show 60% of participants have clinically significant improvements in their physical health after a year in the program.

Health professionals today routinely help patients access support services, like food and income assistance, that are crucial for their mental and physical health. Organizations, like Health Leads, have stepped in to manage some of this support. They encourage doctors and social workers to “prescribe” resources like food, and volunteers help by managing the logistics of things like transportation or application assistance.

Feed The Vulnerable Families Foundation works provides free medicine, checkups, and help with medical bills to people living with diabetes. The organization collaborates with health centers across 32 states to identify people who would benefit from services and reaches medical volunteers through its social media platforms. During outreach events, people are tested for diabetes, given free medications and education materials about living with the disease, and more serious cases are referred to local hospitals for urgent care.