How Federal Agencies Can Improve Americans’ Health and Well-Being

Federal agencies have the opportunity and responsibility to integrate the social determinants of health into their missions and their work.

In 2020, the United States life expectancy fell drastically, putting it at its lowest level since 2003. With all the technology that the country possesses and despite spending more money on healthcare than any other country, the US now ranks 26th out of the 35 countries that comprise the Organization for Economic Co-operation and Development (OECD). Public health experts are now studying the factors leading up to this decline, the social determinants of health. These include employment status, income, education, food security, housing, the environment, and even transportation.

The Department of Health and Human Services has now made it a priority to improve the social determinants of health. They have begun a program called Healthy People 2030 that sets data driven national objectives for health and well-being. Last September, HHS and a nonprofit called Center for Open Data Enterprise hosted an event in which they brought experts from different sectors to discuss how to improve the SDOH. The roundtable proved to show how interrelated the different aspects of SDOH are, identified different cases in different sectors, and discussed how federal agencies could address them.

An example of this would be recent work by the Federal Transit Administration. They identified the importance of transportation to healthcare access. The purpose was how to apply these learnings and how the agency could support programs in communities that are far from healthcare facilities with reliable and affordable transportation, or to build bike paths or sidewalks to make it easier for exercise.

Transportation is closely tied to housing and in 2017 an assessment by the Government Accountability office revealed that 15% of rental units have issues including water leaks, rodents, low air quality, and defective heating. “The Department of Housing and Urban Development could set SDOH-driven targets around lead abatement, indoor air quality, air conditioning for residences with extreme heat risk, and other factors. It is vital to proactively address these issues, many of which are being compounded by climate change” (Gurin 22).

Climate change happens to be a very large threat across the SDOH. The National Oceanic and Atmospheric Administration, the Federal Emergency Management Agency, and the White House Office of Science and Technology are currently working on ways to expand information on hazards like flooding, drought, and fire. The agencies can then look at these issues through a SDOH lens to help them develop specific objectives in order to address the impacts of climate on health and well-being. “CODE’s report on the roundtable includes a number of action opportunities for federal agencies to improve SDOH conditions for all Americans. CODE is also publishing a cross-sector SDOH data hub that shows the wealth of data on SDOH factors that already exists, and makes it easily accessible for analysis. CODE’s report highlights opportunities to make progress by adapting and applying Healthy People 2030 to the state and local level; coordinating work on the SDOH within and between federal agencies more effectively; setting targets for progress in underrepresented areas, using an equity lens; and making SDOH data easier to access and use. CODE is also continuing its work on SDOH with a focus on its application to racial equity. On April 6, CODE co-hosted a webinar  to explore that topic and other applications of open government data for racial equity in healthcare, and featured speakers from government and the private sector” (Gurin 22).

Overall, this gives federal agencies across the government an opportunity to share in the responsibility of protecting the American people. 2020 brought about so much uncertainty with the pandemic, more climate change, racial injustice, and economic uncertainty. Along with HHS and SDOH, who have already built the framework and laid the foundation, the agencies now can focus on their responsibility of American’s health and can set goals to achieve a healthier nation.

By: Beth Gray