HJAR Mar/Apr 2020

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2020 39 LaShannon Spencer Chief Executive Officer Community Health Centers of Arkansas “Health inequalities and the social determinants of health are not a footnote to the determinants of health. They are themain issue.” – SIR MICHAEL MARMOT, DIRECTOR OF THE INSTITUTE FOR HEALTH EQUITY, UNIVERSITY COLLEGE LONDON which can improve population health while reducing costly, avoidable hospitalizations, emergency department and urgent care vis- its, and expensive specialty services. Why the lack of appreciation for non- emergent or non-specialist physicians? Rel- ative to disease-specific research, academic studies have not fully addressed primary care-oriented studies. It is also clear that the lack of recognition for the great work in primary care settings results in many medi- cal students choosing specialty care, where they can often earn more money and have better work hours. It is my belief that os- teopathic medical schools’ graduates who choose family medicine as their specialty are focused on improving patient outcomes and are members of a group who feel a sense of commitment to the social responsibility of medicine. Asubstantial proportion of health care for America’s underserved population is pro- vided by physicians and clinicians within Community Health Centers (CHCs) across the United States. These health centers see the impact of SDOH every day through the needs of their patients. Family physicians and their health care teams are critical in addressing the patients’ SDOH because pri- mary care is a natural point of integration among clinical care, public health, behav- ioral health, and community-based services. Many research articles have indicated that most of the underserved populations reside in rural communities. Rural com- munities often lack community-based re- sources and services, widening the gap of holistic care that can be delivered to the un- derserved rural population. Many times, the only medical establishment within a 20-mile radius frompoints in rural Arkansas is either a small, primary-care single provider or a CHC. Specialists, and even fully functioning hospitals are often outside the reach of the underserved rural population. Primary-care facilities within these rural populations have had to think outside the box to determine how they can assist their patient population in a manner that best fits the patients’ needs, abilities, socioeco- nomic situation, and geographical location. One area in particular CHCs have focused on is Health Information Technology (HIT). As members of the community themselves, CHCs are very mindful that a “digital divide” negatively impacts the underserved rural Ar- kansas population, and focus their patient assistance plans accordingly. The digital divide is the gap between those who have access to technology or the internet and those who do not. Differences are often driven by socioeconomic status. Over the last few years, there has been an increased em- phasis on integrating technology intomedical care, and lack of reliable Internet access can hinder a person’s ability to access medical portals or electronic health records (EHRs). According to a 2019 PEW Research study, seniors are much more likely than younger adults to say they never go online (27 percent compared to 10 percent of the population younger than 65). In 2017, theAmericanMedical Informatics Association stated that access to broadband is, or will soon become, a SDOH. The lack of access to reliable and affordable internet or mobile service limits not only a person’s ability to utilize technology for health-related purposes, but also their ability to access other essential services, such as emergency assis- tance or employment opportunities. Lack of