Penn event discusses the challenges of integrating human services with health care

The Leonard Davis Institute of Health Economics hosted a virtual seminar in which panelists discussed how human service workers can partner with medical professionals to provide optimal health care to community members.

The event, titled “Addressing Social Needs to Improve Health,” featured a panel of health care and social work experts, who discussed health care’s role in filling social service gaps. Perelman School of Medicine and Wharton School professor Rachel M. Werner moderated the March 5 conversation among Dean of Boston University School of Social Work Jorge Delva, Managing Director of Social Interventions Research and Evaluation Network Caroline Fichtenberg, and Chief Executive Officer of Camden Coalition of Healthcare Providers Kathleen Noonan.

Panelists said that the current health care system does not emphasize personalized care according to social needs. Hospitals and clinics tend to focus on the physical issues without focusing on the social contexts in which their patients live.   

Noonan said during the panel that the lack of emphasis on social needs in the health care system is a public policy issue. Even though hospitals have made individual solutions to address social needs, there is no state or federal guidance requiring hospitals to better address social determinants of health.

“I ultimately look at our policymakers as the ones that have to figure out how to solve some of these issues,” Noonan said.

Some of the challenges in integrating health and human services are also due to differences in funding, Fichtenberg said in the panel. Because the health care sector has more resources and technology, she said much of health care reform is motivated by health care priorities, creating misaligned incentives.

“There are challenges of two sectors coming together that have different languages and cultures — different ways of operating,” Fichtenberg said.

Another challenge in integrating the two fields is that the social work profession is not well understood, especially when it comes to social workers collaborating with medical providers to deliver health care, Delva said in the panel.

Although human services and health care delivery are far from being integrated, Delva said the Affordable Care Act has been important in making social work more prominent in delivering health care. Social workers played a leading role in the implementation of the Act by serving as patient navigators, care coordinators, and behavioral health counselors. 

Delva proposed several solutions to foster a greater understanding of how social workers fit into health care. He said in an interview that many social work programs around the country have developed programs where social work students take classes with medicine, public health, or nursing students. Lecturers can come from various fields, such as medicine, nursing, or social work, to provide insight into the different responsibilities of each profession. 

Students who are exposed to a range of experiences during schooling can encourage collaboration across health professions early in their career, Delva told The Daily Pennsylvanian.

Panelists also noted recent successes in the integration of social services with health care. Fichtenberg said screening for social needs in clinical settings has become more common in recent years. Patients are comfortable with health care professionals asking them about social risks in a clinical setting, as long as there is no stereotyping, she added. 

Delva said there is a need for innovation in determining potential solutions to integrate health and human services. Noonan added that, with greater investment in public health, state governments can focus on building a stronger public health system in which hospital systems are participants in a system focused on addressing social needs, rather than leading the movement themselves. 

"We are, right now, at a time where we are seeing so much experimentation,” Fichtenberg said. “There’s a lot possible that we are going to be seeing more of in the future.”