HHS invests in strategies to expand equitable access to comprehensive, community-based, innovative, and culturally-competent healthcare services while addressing social determinants of health. HHS supports community-based healthcare services to meet the diverse healthcare needs of underserved populations while removing barriers to access to advance health equity and reduce disparities. The Department also works to understand how to best address social determinants of health in its programs. Below is a selection of strategies HHS is implementing.
In the context of HHS, this Strategic Plan adopts the definition of underserved populations listed in Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities through the Federal Government to refer to "populations sharing a particular characteristic, as well as geographic communities, who have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life"; this definition includes individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality. Individuals may belong to more than one underserved community and face intersecting barriers.
Contributing OpDivs and StaffDivs
ACL, AHRQ, ASPE, CDC, CMS, HRSA, IHS, NIH, SAMHSA, OASH, and OCR work to achieve this objective.
Strategies
Support community-based services to meet the diverse healthcare needs of underserved populations
- Deliver safe, affordable, accessible, quality, value-based primary healthcare to underserved populations through health centers and other community providers.
- Address COVID-19 related health disparities and advance health equity by expanding state, local, US territorial, and freely associated state health department capacity and services to improve and increase testing and contact tracing and prevent and control COVID-19 infection or transmission.
- Ensure the provision of safe, culturally-competent care and services for women, with dedicated focus on African American/Black and American Indian/Alaska Native women and people with lower incomes, during maternal, perinatal, prenatal, and postpartum periods of life, including raised awareness of pregnancy-related risk factors and available benefits.
- Work with tribal nations and Urban Indian Health programs to expand and improve pre- and post-natal care on Indian reservations and Urban Indian centers to reduce disparities in maternal and infant mortality and morbidity.
- Promote partnerships to implement programs and outreach that focus on raising awareness and rapidly linking affected individuals to relevant care and treatment services, including persons harmed by substance use disorders and persons with HIV.
- Promote linkages to treatment and interventions aimed at reducing exposure and excessive use of alcohol and other substances to achieve healthier outcomes, including optimal pregnancy outcomes.
- Expand access to oral healthcare, including diagnostic, preventive, and restorative services, and health care settings that provide oral healthcare, and promote collaborative practices to integrate oral health and primary care to improve health outcomes.
- Continue to expand equitable access to quality sexual and reproductive health services, including family planning services.
- Continue to promote and support programs that invest in rural collaborations and encourage efforts designed to improve rural healthcare system capacity and infrastructure to facilitate delivery of equitable healthcare services that can comprehensively address the health, social, and economic needs of a wide range of population groups.
- Extend and enhance the lives of individuals in all communities through improving access to safe organ transplantation, bone marrow transplants, and cord blood transplants.
- Improve access to community-based care by supporting appropriate retention of telehealth flexibilities implemented for the COVID-19 pandemic, increasing access to broadband, and providing technical assistance, training and information for patients and providers on the use of telehealth technologies.
- Facilitate the delivery of technology-based interventions and innovations, including the development and dissemination of electronic health record standards, to enable interoperable data exchange across health and community service providers and emerging artificial intelligence solutions to improve care management.
Remove barriers to healthcare access to advance health equity and reduce disparities
- Build capacity of resource centers, healthcare organizations and the health workforce to reduce health and healthcare disparities, including cultural competence capacity to provide culturally and linguistically appropriate services (CLAS).
- Promote adoption of national CLAS standards to enable providers to demonstrate cultural humility through self-awareness and communicate in ways that consider the cultural, health literacy, and language access services needs of their patients.
- In collaboration with private and non-profit organizations, develop patient safety bundles and decision aids like protocols and checklists for health conditions that disproportionally affect underserved populations and work with national accreditation organizations to promote their use in clinics across the nation.
- Collect, use, and monitor data on the prevalence and causes of conditions, including social, environmental, and biological risk factors, and establish partnerships between healthcare providers and community-based social service organizations to address social determinants of health.
- Support state, local, tribal, and territorial jurisdictions to develop multi-sector action plans to address social determinants of health, in sectors such as housing, transportation, and social services, and accelerate actions that lead to improved chronic disease outcomes among persons experiencing health disparities and inequities in communities with the poorest health outcomes.
- Increase access to affordable, accessible housing, and other services that address unmet social needs that contribute to poor health outcomes and reduce unnecessary healthcare expenditures through the HHS and U.S. Department of Housing and Urban Development housing partnership and other partnerships.
- Engage community members to provide input to plan and implement services and programs and conduct participatory research to ensure that activities are tailored and responsive to community needs.
Understand barriers to access and the impacts of social determinants of health to develop evidence-based community-based healthcare service delivery models
- Expand efforts to collect data that improves understanding of the social determinants of health and their implications for delivering equitable and effective health, public health, and human service programs.
- Partner with healthcare organizations, healthcare providers, social service organizations, and other organizations to identify, develop and implement evidence-based community-based healthcare service delivery models to support whole person integrated and coordinated care to improve physical health and behavioral health outcomes.
- Support community-based participatory research, and other research approaches, to examine the effectiveness of community-based service delivery models, in improving health outcomes across populations, including collecting and stratifying data based on race, ethnicity, national origin (including primary language), sex, sexual orientation, gender identity, and pregnancy, age, disability status, and other population variables.
- Support research on telehealth to answer questions related to how it affects access to the care and the quality and cost of care, including for underserved populations.
